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Office Visits for Prescriptions

12/29/2016

Prescribers should not require an office visit just to order a refill.

Many prescribers and clinics, as a matter of policy, require a patient encounter before ordering a refill, either in order to get payment for the work or in order to feed the fantasy that it prevents diversion. In my opinion the benefit fails to justify the inconvenience and cost.

Requiring an office visit just to get paid for ordering a refill can unnecessarily inconvenience the patient and can hurt them if they have to go without needed treatment until the prescriber has an available slot. Patients work, travel, get sick and have transportation problems. We all take holidays, and prescribers have limited office hours.

Patient encounters do not prevent drug diversion.

We should base frequency of patient encounters on clinical necessity, not payment. A prescriber can justify requiring an office visit (or videoconference) at any time before ordering any medication if he or she genuinely needs to confirm appropriateness of the drug.

Although I do not recommend it, prescribers who want payment for each task they perform can charge a reasonable fee for ordering a refill between encounters, but use of eprescribing instead of time consuming phone calls can take only seconds.